Endovascular Treatment in Patients with Acute Ischemic Stroke
Keywords:
endovascular treatment, mechanical thrombectomy, thrombolysis, acute strokeAbstract
Patients with acute large middle cerebral artery or internal carotid artery infarction have poor prognosis and high mortality rate. Although intravenous recombinant-tissue-plasminogen activator (rt-PA) is the only treatment recommended in eligible patients within 4.5 hours of stroke onset, the benefit in patients with severe stroke is moderate. Recent studies showed the benefit in terms of higher rate of favorable outcome and lower mortality in patients who received intravenous rt-PA and endovascular treatment, using stent-retriever devices, as compared to standard treatment. However, patients in those trials were carefully selected. Most trials required CT, CTA or CTP in patients’ selection. Patients with small infarct core, salvageable brain tissue, moderate to good collateralization, and occluded M1, M2 or ICA who received intravenous rtPA and early endovascular treatment had better outcome as compared to standard treatment or intravenous rt-PA treatment alone.
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